An Act To amend the Internal Revenue Code of 1986 to improve portability and continuity of health insurance coverage in the group and individual markets, to combat waste, fraud, and abuse in health insurance and health care delivery, to promote the use of medical savings accounts, to improve access to long-term care services and coverage, to simplify the administration of health insurance, and for other purposes. HIPAA

Title I: Health Care Access, Portability, and Renewability
Title I of HIPAA regulates the availability and breadth of group health plans and certain individual health insurance policies. It amended the Employee Retirement Income Security Act, the Public Health Service Act, and the Internal Revenue Code. Title I requires the coverage of and also limits restrictions that a group health plan can place on benefits for preexisting conditions. Group health plans may refuse to provide benefits relating to preexisting conditions for a period of 12 months after enrollment in the plan or 18 months in the case of late enrollment. Title I allows individuals to reduce the exclusion period by the amount of time that they had "creditable coverage" prior to enrolling in the plan and after any "significant breaks" in coverage. "Creditable coverage" is defined quite broadly and includes nearly all group and individual health plans, Medicare, and Medicaid. A "significant break" in coverage is defined as any 63 day period without any creditable coverage. Title I [13] also requires insurers to issue policies without exclusion to those leaving group health plans with creditable coverage (see above) exceeding 18 months, and [14] renew individual policies for as long as they are offered or provide alternatives to discontinued plans for as long as the insurer stays in the market without exclusion regardless of health condition. Some health care plans are exempted from Title I requirements, such as long-term health plans and limited-scope plans such as dental or vision plans that are offered separately from the general health plan. However, if such benefits are part of the general health plan, then HIPAA still applies to such benefits. For example, if the new plan offers dental benefits, then it must count creditable continuous coverage under the old health plan towards any of its exclusion periods for dental benefits. An alternate method of calculating creditable continuous coverage is available to the health plan under Title I. That is, 5 categories of health coverage can be considered separately, including dental and vision coverage. Anything not under those 5 categories must use the general calculation (e.g., the beneficiary may be counted with 18 months of general coverage, but only 6 months of dental coverage, because the beneficiary did not have a general health plan that covered dental until 6 months prior to the application date). Since limited-coverage plans are exempt from HIPAA requirements, the odd case exists in which the applicant to a general group health plan cannot obtain certificates of creditable continuous coverage for independent limited-scope plans such as dental to apply towards exclusion periods of the new plan that does include those coverages. Hidden exclusion periods are not valid under Title I (e.g., "The accident, to be covered, must have occurred while the beneficiary was...

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, inequality
Fully justified: fair,
Agree | Disagree |
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doctor pull the cord?
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1429 words - 6 pages
operations per operation theatre. Minimum time required for 6 first time operations is 45mins *6 = 4.5 hours. From 1-4 pm, there will also be examination of newly entering patients, hence the doctors who are not operating will be in charge of this. Let us assume that 5 doctors will operate and 5 will not per day. So amongst the ones that don’t operate, they will be free during the first half of the day (5 hours*5 doctors).
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4869 words - 20 pages
placement at seminars.Trust of prescriber on MNC brand, R & D investment high for Quality Strong at cardiovascular products. |
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1172 words - 5 pages
my employees and how we are going to handle this. If there was a huge side effect on the drug, then the doctor did not fully let the patient know about the effects, and that is a lack of external face to face communication between my sales rep and the doctor. “Despite this lack of knowledge, doctors is likely to start prescribing these drugs after visits from company representatives, according to the findings from questionnaires completed by

1090 words - 5 pages
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2069 words - 9 pages
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3311 words - 14 pages
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